Fluid Measurements and MRI in Determining Biomarkers of Lymphatic Dysfunction in Patients with Breast Cancer

Inclusion Criteria

• AIM 1: Females (over the age of 18 years) planning to have unilateral axillary lymph node removal surgery as a component of their cancer regime.
• AIM 1: Or females (over the age of 18 years) without history of cancer or lymphedema to serve as study controls.
• AIM 2: Females (over the age of 18 years) who have already had unilateral axillary lymph node removal surgery as a component of their cancer regime in the “at risk” side being monitored for lymphedema development.
• AIM 3: Females (over the age of 18 years) diagnosed with unilateral secondary lymphedema in the upper quadrant and/or extremity following cancer related surgery involving removal of any axillary lymph nodes and/or radiation therapy.

Exclusion Criteria

• Subjects who have any type of non-MRI compatible bioimplant activated by mechanical, electronic, or magnetic means (e.g., cochlear implants, pacemakers, neurostimulators, biostimulators, electronic infusion pumps, etc.), because such devices may be displaced or malfunction.
• Subjects who have any type of ferromagnetic bioimplant that could potentially be displaced.
• Subjects who have cerebral aneurysm clips.
• Subjects who may have shrapnel imbedded in their bodies (such as from war wounds), metal workers and machinists (potential for metallic fragments in or near the eyes).
• Minors (younger than 18 years).
• Pregnant women.
• Subjects who have open wounds on either wrist and/or right ankle because of contraindications with placement of electrodes to obtain the L-DEX U400 readings.
• Also excluded are subjects incapable of giving informed written consent: * Subjects who are non-English speaking, children/minors, pregnant women/fetal tissue/placenta, cognitively impaired, prisoners. * Subjects who cannot adhere to the experimental protocols for any reason, or have an inability to communicate with the researcher. * Subjects who have limited mental ability to give informed consent, mentally retarded, altered mental status, mental disability, confusion, or psychiatric disorders. * Prisoners.
• To minimize discomfort, we will also exclude subjects who exhibit noticeable anxiety and/or claustrophobia or who exhibit severe vertigo when they are moved into the magnet.
• AIM 1: Any contraindication to MRI.
• AIM 1: Any axillary lymph node removal procedure already performed before study visit.
• AIM 1: Persons who are deemed clinically unsuitable for an MRI by their treating physician.
• AIM 1: Severe claustrophobia.
• AIM 1: To minimize discomfort, we will also exclude subjects who exhibit noticeable anxiety and/or claustrophobia or who exhibit severe vertigo when they are moved into the magnet. All participants will be screened with the safety screening form currently used for research studies on all research MRI scanner.
• AIM 1: Open wounds on right ankle or bilateral wrists for purposes of obtaining external L-Dex extracellular fluid reading.
• AIM 1: Subjects incapable of giving informed written consent: * Subjects who are non-English speaking. * Subjects who cannot adhere to the experimental protocols for any reason, or have an inability to communicate with the researcher. * Subjects who have limited mental ability to give informed consent, mentally retarded, altered mental status, mental disability, confusion, or psychiatric disorders.
• AIM 1: Prisoners.
• AIM 2: Any contraindication to MRI.
• AIM 2: Persons with signs or symptoms of lymphedema before their first MRI study visit for their “at risk side” being monitored for lymphedema development.
• AIM 2: Persons who are deemed clinically unsuitable for an MRI by their treating physician.
• AIM 2: Severe claustrophobia.
• AIM 2: Minors (younger than 18 years).
• AIM 2: To minimize discomfort, we will also exclude subjects who exhibit noticeable anxiety and/or claustrophobia or who exhibit severe vertigo when they are moved into the magnet. All participants will be screened with the safety screening form currently used for research studies on all research MRI scanners.
• AIM 2: Open wounds on right ankle or bilateral wrists for purposes of obtaining external L-Dex extracellular fluid reading.
• AIM 2: Also excluded are subjects incapable of giving informed written consent: * Subjects who are non-English speaking. * Subjects who cannot adhere to the experimental protocols for any reason, or have an inability to communicate with the researcher. * Subjects who have limited mental ability to give informed consent, mentally retarded, altered mental status, mental disability, confusion, or psychiatric disorders.
• AIM 2: Prisoners.
• AIM 3: Any contraindication to MRI.
• AIM 3: Persons who have undergone bilateral axillary lymph node removal and thus are at risk for bilateral secondary lymphedema.
• AIM 3: Persons who are deemed clinically unsuitable for an MRI or lymphedema therapy by their treating physician.
• AIM 3: Severe claustrophobia.
• AIM 3: Minors (younger than 18 years).
• AIM 3: To minimize discomfort, we will also exclude subjects who exhibit noticeable anxiety and/or claustrophobia or who exhibit severe vertigo when they are moved into the magnet. All participants will be screened with the safety screening form currently used for research studies on all research MRI scanners and the manual lymphatic drainage screening form administered by a licensed lymphedema physical therapist.
• AIM 3: Open wounds on right ankle or bilateral wrists for purposes of obtaining external L-Dex extracellular fluid reading.
• AIM 3: Also excluded are subjects incapable of giving informed written consent: * Subjects who are non-English speaking. * Subjects who cannot adhere to the experimental protocols for any reason, or have an inability to communicate with the researcher. * Subjects who have limited mental ability to give informed consent, mentally retarded, altered mental status, mental disability, confusion, or psychiatric disorders.
• AIM 3: Prisoners.